Provider Demographics
NPI:1063694602
Name:CAPEHART, NIVEA DONETTE (OTR/L)
Entity type:Individual
Prefix:
First Name:NIVEA
Middle Name:DONETTE
Last Name:CAPEHART
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8720 JACKSON SPRINGS RD
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33613-3131
Mailing Address - Country:US
Mailing Address - Phone:813-972-2700
Mailing Address - Fax:
Practice Address - Street 1:8720 JACKSON SPRINGS RD
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33615-3210
Practice Address - Country:US
Practice Address - Phone:813-972-2700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-12-05
Last Update Date:2023-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOT12558225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist